POS0699 GIANT CELL ARTERITIS CLINICAL DISEASE ACTIVITY MEASURES: RECOMMENDATIONS FOR USE IN CLINICAL PRACTICE
Authors: Y. El Miedany, M. Elgaafary, M. Toth, S. Bahlas, M. H. Abu-Zaid, W. Hassan, D. Palmer, S. A. Mahran, S. A. A. Tabra, W. Elwakil, S. Saber
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Although the systematic measurement of disease activity facilitates clinical decision making in Giant Cell Arteritis (GCA), no recommendations currently exist on which measures should be applied in clinical practice. <h3>Objectives</h3> To comprehensively evaluate the validity, feasibility, and acceptability of available GCA disease activity measures and derive recommendations for their use in clinical practice. <h3>Methods</h3> This was a 6-phases process which included a combination of a systematic literature review, psychometric analyses, validated group methods, and physician surveys. In phase 1, The GCA clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify GCA disease activity measures. Applying exclusion criteria: measurement tools were excluded from further consideration if they: (1) measured imaging only; (2) did not report a continuous value; (3) had insufficient information (e.g. not yet published in manuscript form.). Phase 2: Expert panel were asked to rank the remaining measures via an electronic survey. For each measurement tool, expert panel members were asked to indicate whether they were familiar with the measure (yes, no), whether they had ever used the measure (yes, no), and whether they would recommend the measure for clinical use (yes, no). The survey instructed the expert panel to apply the Outcome Measures for Arthritis Clinical Trials (OMERACT) filter of truth, discrimination, and feasibility as a guide when ranking their top five choices for use in clinical practice. The panel members were encouraged to identify additional measures not listed. Phase 3: following teleconferences the list of measures was reduced based on their rankings and panel comments. Phase 4: included comprehensive examination of the psychometric properties (reliability, validity, and responsiveness) of the remaining GCA disease activity measures. Phase 5 included an electronic survey to score the usefulness and feasibility in clinical practice and acceptance to use the tool on a regular basis when caring for patients. Phase 6: the final list of GCA disease activity measures was prepared. <h3>Results</h3> Using the list of specific disease activity measures as keyword searches, the systematic review of the literature resulted in identification of 21 GCA disease activity measures. Application of exclusion criteria and ratings by the expert panel narrowed the list to 10 measures for further evaluation. Practicing rheumatologists rated 7 of these 10 measures as most useful and feasible. From these 7 measures, the working group selected 6 with the best psychometric properties for inclusion in the final set of recommended GCA disease activity measures. <h3>Conclusion</h3> The GCA Clinical Disease Activity Index, has been developed including severity of headache (using 0-100 VAS), acute visual deficit (0-100 VAS), functional disability (0-3), Lab disease activity measures: ESR and CRP, patient global assessment (0-100 VAS), physician global assessment (0-100 VAS). These were identified as they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.